整治前后我院住院患者抗菌药物使用强度分析

目的:了解整治前(2010年)、后(2011年)我院住院患者抗菌药物的使用强度(AUD)。方法:以约定日剂量(DDD)为指标,计算抗菌药物的AUD。结果:整治前、后我院住院患者抗菌药物的AUD分别为86.49、70.66DDDs/100人/天,整治后第3代头孢菌素、硝基咪唑类和第4代头孢菌素的AUD排序列前3位,分别为14.95、8.37和8.18DDDs/100人/天。整治前、后AUD排序列前10位的药品均来自头孢菌素类、青霉素类+酶抑制剂、硝基咪唑类、喹诺酮类、大环内酯类和青霉素类;绝大多数都是注射剂;各科室抗菌药物的AUD以呼吸科、消化医学中心和泌尿外科列前3位,整治后分别为156.92、139.64和114.96DDDs/100人/天。同国内、外其他医院比较,我院整治前的AUD略高于2005-2007年卫生部抗菌药物临床应用监测网报道的AUD,整治后低于监测网报道的AUD;与美国和韩国某医院的调查数据比较存在较大差异。结论:我院存在抗菌药物应用过度、集中、广谱抗菌药物使用率较高等问题,AUD离卫生部规定的目标值(40DDDs/100人/天)还存在较大差距,应进一步加强抗菌药物应用的监督管理。

Analysis of the Antibiotics Use Density in Our Hospital before and after Special Campaigns

OBJECTIVE:To investigate antibiotics use density(AUD) in the inpatients in our hospital before(2010) and after(2011) special campaigns.METHODS:Taking DDD as index,AUD were calculated by the value of DDDs/100 persons/day.RESULTS:The value of AUD was 86.49 and 70.66 before and after special campaigns.The third generation cephalosporins,nitromidazoles and the fourth generation cephalosporins ranked in the first three places,the mean value of AUD was 14.95,8.37 and 8.18.The drugs ranking in the first ten places came from cephalosporin,penicillin+enzyme inhibitor,nitromidazoles,fluoroquinolones,macrolides and penicillin,and the majority of antibiotics were injection.The respiration department,the digestive medical center and urology surgery department ranked top three in the list of AUD,the value of AUD after special campaigns was 156.92,139.64 and 114.96.Compared with the domestic and foreign hospitals,AUD of antibiotics in our hospital before special campaigns was higher than that published by antibiotics monitoring network of Ministry of Health,while AUD of antibiotics after special campaigns was lower than reported data;it was significantly different from the data of hospitals in Korea and the USA.CONCLUSION:There may be such problems as overmedication,dense medication and the higher ratio of broad spectrum antibiotics use in our hospital.AUD and desired value(40 DDDs/100 persons/day) still have a large gap.It is necessary to strengthen the supervision and administration.